Objective: By comparing the difference of clinical curative effect between microwave ablation of benign nodules and microwave ablating thyroid benign nodules by moving-shot technique and fixed-needle technique,a safer and more effective ablation method can be selected for microwave ablation of benign thyroid nodules.Methods: To study the clinical data of 72 patients with benign thyroid nodules undergoing microwave ablation in our hospital from January 2016 to March 2017.According to the ablation method,the patients were divided into moving-shot technique group(40)and fixed-needle technique group(32).The parameters of ablation,ablation range,changes of thyroid function before and after ablation and the occurrence and outcome of complications were compared.After 1,3,6,9 Month follow-up,measurement of ablation nodules volume,compare the volume reduction rate differences.Using SPSS22.0 mathematical statistics software for statistical analysis of the treatment effect of all patients.Results: Both thermal ablation and fixed needle ablation achieved satisfactory results in microwave ablation of benign thyroid nodules.There was no significant difference in total ablation time between moving-shot technique group and fixed needle ablation group(P > 0.05).Excluding the influence of nodule volume,the unit volume ablation time of moving-shot technique group was lower than that of fixed-needle technique group,the difference was statistically significant(P <0.05).Thyroid function did not change significantly in both groups before and after ablation(all P > 0.05).Twenty patients underwent surgery with mild pain and mild pain in the neck,and 7 and 13 patients in the ablation group and the ablation group respectively.The difference was statistically significant(P <0.05).All patients can tolerate pain without pain medication.In 4 patients,hemorrhage was observed between the nodules and the trachea by color Doppler ultrasonography.There were 3 cases of moving-shot technique group and 1 case of fixed needle ablation group,the difference was not statistically significant(P > 0.05).Thirteen patients had acoustic changes after surgery,4 cases of moving-shot technique group and 9 cases of fixed needle ablation group,the difference was statistically significant(P <0.05).In the fixed needle ablation group,one patient was diagnosed as recurrent laryngeal nerve(RLN)with a RLN injury rate of 1.3%.After treatment,follow-up patients after a month the sound returned to normal.No skin burns,trachea,esophageal injury,drinking cough,hematoma and other complications.All cases were followed up for 9 months.All nodules were reduced to varying degrees,with statistical significance(all P <0.05).The average volumetric reduction rate of all nodules was(82.78 ± 6.72)%.Comparing the grouping and different follow-up time,the volumetric reduction rate of the nodules in the moving-shot technique group was larger than that in the fixed-needle technique group,in which the volume was reduced in the third,sixth and ninth months after operation Small differences were significant(all P <0.05).Clinical follow-up in September showed that all patients achieved significant clinical symptoms(nodules volume was reduced ≥50% compared with that before treatment),in which four cases(13.3%)of moving-shot technique group disappeared completely and reached the standard of cure.2 cases(6.25%),the difference was not statistically significant P > 0.05).Conclusion: MWA is a newly developed minimally invasive technique for the treatment of benign thyroid nodules.It is a safe and effective surgical alternative to reduce and eliminate nodules and relieve clinical symptoms.Through short-term follow-up,compared with fixed-needle technique,moving-shot technique technique has the advantages of high ablation efficiency,low complication rate and more complete nodule absorption,which is worth popularizing in clinic. |